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2020 international consensus on ANCA testing beyond systemic vasculitis

Moiseev, Sergey ; Cohen Tervaert, Jan Willem ; Arimura, Yoshihiro ; Bogdanos, Dimitrios P. ; Csernok, Elena ; Damoiseaux, Jan ; Ferrante, Marc ; Flores-Suárez, Luis Felipe ; Fritzler, Marvin J. and Invernizzi, Pietro , et al. (2020) In Autoimmunity Reviews
Abstract

This document follows up on a 2017 revised international consensus on anti-neutrophil cytoplasm antibodies (ANCA) testing in granulomatosis with polyangiitis and microscopic polyangiitis and focuses on the clinical and diagnostic value of ANCA detection in patients with connective tissue diseases, idiopathic interstitial pneumonia, autoimmune liver diseases, inflammatory bowel diseases, anti-glomerular basement membrane (GBM) disease, infections, malignancy, and during drug treatment. Current evidence suggests that in certain settings beyond systemic vasculitis, ANCA may have clinical, pathogenic and/or diagnostic relevance. Antigen-specific ANCA targeting proteinase-3 and myeloperoxidase should be tested by solid phase immunoassays in... (More)

This document follows up on a 2017 revised international consensus on anti-neutrophil cytoplasm antibodies (ANCA) testing in granulomatosis with polyangiitis and microscopic polyangiitis and focuses on the clinical and diagnostic value of ANCA detection in patients with connective tissue diseases, idiopathic interstitial pneumonia, autoimmune liver diseases, inflammatory bowel diseases, anti-glomerular basement membrane (GBM) disease, infections, malignancy, and during drug treatment. Current evidence suggests that in certain settings beyond systemic vasculitis, ANCA may have clinical, pathogenic and/or diagnostic relevance. Antigen-specific ANCA targeting proteinase-3 and myeloperoxidase should be tested by solid phase immunoassays in any patient with clinical features suggesting ANCA-associated vasculitis and in all patients with anti-GBM disease, idiopathic interstitial pneumonia, and infective endocarditis associated with nephritis, whereas in patients with other aforementioned disorders routine ANCA testing is not recommended. Among patients with autoimmune liver diseases or inflammatory bowel diseases, ANCA testing may be justified in patients with suspected autoimmune hepatitis type 1 who do not have conventional autoantibodies or in case of diagnostic uncertainty to discriminate ulcerative colitis from Crohn's disease. In these cases, ANCA should be tested by indirect immunofluorescence as the target antigens are not yet well characterized. Many questions concerning the optimal use of ANCA testing in patients without ANCA-associated vasculitis remain to be answered.

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@article{d0cbf198-7431-4b1e-8ad0-eefdb16ec9a1,
  abstract     = {<p>This document follows up on a 2017 revised international consensus on anti-neutrophil cytoplasm antibodies (ANCA) testing in granulomatosis with polyangiitis and microscopic polyangiitis and focuses on the clinical and diagnostic value of ANCA detection in patients with connective tissue diseases, idiopathic interstitial pneumonia, autoimmune liver diseases, inflammatory bowel diseases, anti-glomerular basement membrane (GBM) disease, infections, malignancy, and during drug treatment. Current evidence suggests that in certain settings beyond systemic vasculitis, ANCA may have clinical, pathogenic and/or diagnostic relevance. Antigen-specific ANCA targeting proteinase-3 and myeloperoxidase should be tested by solid phase immunoassays in any patient with clinical features suggesting ANCA-associated vasculitis and in all patients with anti-GBM disease, idiopathic interstitial pneumonia, and infective endocarditis associated with nephritis, whereas in patients with other aforementioned disorders routine ANCA testing is not recommended. Among patients with autoimmune liver diseases or inflammatory bowel diseases, ANCA testing may be justified in patients with suspected autoimmune hepatitis type 1 who do not have conventional autoantibodies or in case of diagnostic uncertainty to discriminate ulcerative colitis from Crohn's disease. In these cases, ANCA should be tested by indirect immunofluorescence as the target antigens are not yet well characterized. Many questions concerning the optimal use of ANCA testing in patients without ANCA-associated vasculitis remain to be answered.</p>},
  author       = {Moiseev, Sergey and Cohen Tervaert, Jan Willem and Arimura, Yoshihiro and Bogdanos, Dimitrios P. and Csernok, Elena and Damoiseaux, Jan and Ferrante, Marc and Flores-Suárez, Luis Felipe and Fritzler, Marvin J. and Invernizzi, Pietro and Jayne, David and Jennette, J. Charles and Little, Mark A. and McAdoo, Stephen P. and Novikov, Pavel and Pusey, Charles D. and Radice, Antonella and Salama, Alan D. and Savige, Judith A. and Segelmark, Mårten and Shoenfeld, Yehuda and Sinico, Renato A. and Sousa, Maria José and Specks, Ulrich and Terrier, Benjamin and Tzioufas, Athanasios G. and Vermeire, Severine and Zhao, Ming Hui and Bossuyt, Xavier},
  issn         = {1568-9972},
  language     = {eng},
  month        = {07},
  publisher    = {Elsevier},
  series       = {Autoimmunity Reviews},
  title        = {2020 international consensus on ANCA testing beyond systemic vasculitis},
  url          = {http://dx.doi.org/10.1016/j.autrev.2020.102618},
  doi          = {10.1016/j.autrev.2020.102618},
  year         = {2020},
}